For patients with EIB who have an interest in dietary modification to control
their symptoms:
Î The ATS suggests implementation of a low-salt diet (weak
recommendation, moderate-quality evidence).
Î The ATS suggests dietary supplementation with fish oils (weak
recommendation, low-quality evidence).
Î The ATS suggests against dietary supplementation with lycopene (weak
recommendation, low-quality evidence).
Î The ATS suggests dietary supplementation with ascorbic acid (weak
recommendation, moderate-quality evidence).
Figure 1. Diagnostic and Treatment Algorithm for
Exercise-induced Bronchoconstriction
Symptoms Suggestive of EIB
Exercise Challenge
a
Δ FEVl post-challenge ≥10-15%?
EIB Confirmed
Non-pharmacologic
(prevent symptoms only)
Treat symptoms Prevent symptoms
• SABAs 5-20 min
before exercise
• Consider addition
of MCSA and/or
anticholinergic if
SABA not working
• Warm-up exercise
• Face mask or scarf
• Dietary modification
Used daily or more?
SABAs
YES
Consider Treatment
Pharmacologic
Consider Alternative Dx
NO
Consider addition of controller therapy
(daily ICS+/-LABA, and/or LTRA;
antihistamines if allergic)
Treatment
